No pulse, no breath, no lifeguards

RANCHO SANTA MARGARITA – There was no pulse. No breathing. And Danielle Gaus saw no lifeguards near the unconscious 3-year-old boy when he was pulled from the swimming pool.

A health clinician and CPR instructor, Gaus quickly began compressions on the tiny chest. Fourth of July celebrations at the Beach Club and Lagoon came to an abrupt stop because of the commotion as three more people sprinted toward the boy.

A plea over loudspeakers summoning anyone who knew CPR had caught the attention of two off-duty firefighters and a registered nurse.

All four had backgrounds in emergency care, and they yelled for equipment that could help them get the boy breathing again – an automated external defibrillator, the drug epinephrine, a pediatric CPR mask.

"They had no mask, they had no AED. They had nothing for us to use," Gaus said.

Meanwhile, she said, the monitors she believed were lifeguards for a pool that served more than 500 visitors that day "were nowhere to be found."

Three-year-old Xavier Ergueta died the next day, and though Gaus stops short of saying the equipment would have changed that outcome, her training tells her it could have helped.

The homeowners association that operates the club issued a statement on its website after the drowning, expressing condolences and stating: "All established procedures and policies were followed."

Some residents – including those who performed CPR – have expressed frustration at a lack of equipment, lifeguards and preparation at the pool. Yet pool-safety experts and public officials charged with inspecting these facilities say there are no regulations that require such community pools be equipped with defibrillators or that certified lifeguards be on duty.

Safety requirements for community pools differ only slightly from those of backyard pools.

While associations that operate community pools can implement safety measures, experts say a fear of legal liability and potential for litigation keep them from doing so.

NO LIFEGUARD ON DUTY

It wasn't until the next day that Rabecca Rosk, a registered nurse, wondered why the pool monitor asked over loudspeakers for someone who knew CPR. She heard it at her nearby home and ran to help.

Since moving to Rancho Santa Margarita in January, she believed the teenagers sitting in the three chairs overlooking the pool were lifeguards.

"It says, 'No lifeguard on duty,' on the chairs, but does that mean when they're not in the chairs?" Rosk said. "The perception they give off is they are lifeguards."

Four pool monitors and one supervisor were on duty on the evening of the drowning, said Candice Fullenkamp, community executive officer of the Rancho Santa Margarita Landscape and Recreation Corp. – better known as SAMLARC, the homeowners association that oversees the club.

She emphasized the pool monitors – who carry blue flotation devices while working – are not lifeguards, though they are certified in CPR and have first-aid and lifeguard training. She said the pool monitors enforce rules, watch over the crowds and check water clarity.

SAMLARC had initially issued a statement on its website saying a monitor started CPR on the boy, but the association later retracted that. Rosk and Gaus said they contacted the association's management and said the pool monitors did not perform CPR or tend to the boy.

Anthony Mendoza, an off-duty engineer at the state fire-fighting agency Cal Fire who also helped do CPR, agreed.

"They were just frozen, just standing there, 'What-do-I-do?' kind of a thing," he said. "Their inaction was causing me to do something."

FIRST RESPONDERS

Fullenkamp said Safe Swim, the company that provides pool monitors at the Rancho Santa Margarita pool, informed her later that the monitors responded first but did not perform CPR.

According to its website, Irvine-based Safe Swim trains lifeguards, junior lifeguards and monitors. It also makes them available to homeowners associations and for private parties. The company did not return repeated calls for comment.

Rosk thinks the pool monitors give a false sense of security.

"You look like a lifeguard, you act like a lifeguard, and you're certified as a lifeguard, but you're not a lifeguard?" Rosk said. "And when you have to act like a lifeguard, you can't?"

She is also concerned that there was no defibrillator available. Since that day, she and Gaus have spoken to the homeowners association's management company about placing them there.

"The fact they didn't have an AED is frustrating," Rosk said. "I just wanted to make sure I could do everything I was trained to do."

The American Heart Association advocates placing AEDs in public areas and recommends CPR be performed while an AED is being readied.

Defibrillators have been placed in police patrol cars and public schools, but the state does not require them anywhere except in health clubs.

A study by the American Heart Association found "survival rates for victims of OHCA (out of hospital cardiac arrest) doubled in areas where AEDs were available and cardiac arrest response plans were implemented."

'THE DIFFERENCE IS LIABILITY'

Fullenkamp said pool monitors have been used at the beach club for more than 10 years.

Asked why monitors did not perform CPR, she said it's protocol for monitors to let higher-level professionals take over CPR when available.

Rancho Santa Margarita resident Tess Myers said she's contacted SAMLARC at least three times since 2009 expressing concern about the monitors: "I think the pool monitors aren't necessarily to blame. SAMLARC didn't hire the right people for the kind of facility that we have."

Myers said she feels bad for the monitors who were there on the Fourth of July, teenagers who may not have been prepared for the tragic turn of events. But she wonders how the association made the decision to contract for pool monitors instead of lifeguards.

"I'm dying to know why they made that choice," she said. "I think it gives a false sense of security to have these kids up in the high chairs."

Fullenkamp said it "was a decision made a number of years ago" by a previous board, and SAMLARC is researching the issue.

Attorney David Swedelson said it's a matter of legal responsibility.

"The difference is liability," said Swedelson of Swedelson & Gottlieb, a Los Angeles law firm that specializes in representing community associations. The firm does not represent SAMLARC.

Many homeowners associations hire pool monitors, of whom legal expectations are lower than lifeguards, he said. Their main responsibility is not to survey and protect people from drowning, but to keep order, prevent children from running, and make sure guests are not doing anything disruptive.

By hiring pool monitors, Swedelson said associations can limit the risk of lawsuits.

"It's coupled with putting up a sign or a newsletter saying that we don't have lifeguards, so parents must keep an eye on their children," said Swedelson, who also noted homeowners associations don't equip pools with AEDs for similar liability reasons should the device not work.

B.J. Fisher, director of health and safety for the American Lifeguard Association, said having pool monitors instead of lifeguards can be deceptive. "It's been a terrible issue because the public perceives the two as the same," he said.

DIFFERENT STANDARDS

Lifeguards are required to provide proper care in a medical emergency, while monitors are not always required to know CPR, he said.

Though lifeguards are held to the same standard as firefighters and paramedics, they do not have the same legal protections against punitive damages.

"We need to change the law to protect the individuals who are attempting to save a life," he said. "We are losing our lifeguards because of liability issues. When someone wants to point the finger, if there's a lifeguard, they point their finger to the lifeguard."

"If I was an employer, if I wasn't required to have a lifeguard, I would classify my employees as pool monitors," Fisher said.

Lifeguards, who are certified, might also be paid better than pool monitors, Fisher said.

The day after Xavier Ergueta was pulled from the Beach Club pool, the county Health Care Agency inspected it, checking off the safety equipment required at the community pool: two rescue poles, three life rings with lines and warning signs.

According to California Health and Safety Code, community pools like the lagoon are not required to have lifeguards on duty regardless of the number of visitors. A lifeguard is only required when a direct fee is charged for access to the pool such as at most city-operated pools.

Fire departments and city inspectors examine community pools but do not have jurisdiction over safety features. Orange County Fire Authority Assistant Fire Marshal Kevin Bass said fire officials are looking for access in and out of the pool in case of an emergency. City officials enforce building codes.

There have been 13 drowning deaths in the county this year, the OCFA said. Nearly half of all the possible-drowning calls this year have been at community pools.

Rosk, the nurse, said she just wants to be sure she can do everything she is trained to do. "It's the first 10 minutes that are the most effective and we couldn't be effective."

Mendoza, the off-duty firefighter, said he didn't know how long the boy had been in the water, but the equipment could have helped. "It can't hurt, it can never hurt," he said. "Even if we had the equipment, maybe the outcome would be the same, but what if?"